a site hosted by Medknow Publications. (www.medknow.com). ISSN 0970 - 4388. Early childhood caries and dental plaque among 1-3-year-olds in Tehran,. Iran.
ISSN 0970 - 4388
Early childhood caries and dental plaque among 1-3-year-olds in Tehran, Iran SIMIN Z. MOHEBBI.a,b, JORMA I. VIRTANEN.a, MOJTABA VAHID-GOLPAYEGANI.b, MIIRA M. VEHKALAHTI.a
Abstract The association between plaque and caries in older children and adults has been poor, however, some studies show that there may be a relationship in younger children. The aim was to study the relationships between dental caries and dental plaque among 12-36-month-olds in Tehran, Iran. A cross-sectional study among a stratified random sample of 504 children aged one to three years from 18 public health centres in Tehran. Mothers were interviewed about their child’s date and order of birth, gender, primary caregiver, the mother’s age and the educational level of both parents. Dental examination was carried out according to the WHO criteria. Early childhood caries (ECC) was defined as the presence of any dmf teeth. Dental plaque was visually inspected on the labial surfaces of upper central incisors. Data analysis included Chi-square test, t-test, ANOVA and logistic regression modelling. The prevalence of ECC ranged from 3 to 33% depending on age group, with a mean dt of 1.1 for 26- to 36-month-olds. No gender-differences existed in ECC prevalence and mean dt. Dental plaque was visible on at least one index tooth for 65-75% of the children. Presence of ECC was related to the presence of dental plaque (OR=1.5; 95% CI 1.0-2.3) when controlling for background factors by means of logistic regression. The high occurrence of visible plaque and rather high ECC prevalence call for improvement in oral health promotion programs of the children.
d a o nl s w n io do t a e c e i l health centres. In Iran, r offered in thebpublic f vaccinations Introduction r under 6 yearsuof age.account for about 13% of the children o f total population. P ) the Early childhood caries (ECC) is a devastating form of caries that may affect the primary dentition as soon as infant teeth e m were collected from January w odata l The present cross-sectional erupt. ECC has been defined as the presence of any o b to March m 2005. Target.c subjects included children between n decayed, missing or filled teeth in the dentition of children a o l k 12 and 36 months w of age and their mothers attending the r under 6 years of age and severe ECC (S-ECC) asi any d andodevelopment assessment offices of the aage. f vaccination smooth surface caries in children under 3 years of e v n of Tehran city. Using a list provided by public health centres The prevalence of caries in pre-school children a seems to be M the Ministrykof Health and Medical Education, 18 out of 102 on the decline in most of the developed countries but is s d centres were selected to represent the regions increasing in many developing countries. iThe World Health ypublic health e b in Tehran. The number of selected centres was proportional Organization (WHO), however, has no F database on the oral mtotal number of centres in that region. Four working to.the d health of children less than three years of age. Dental plaque D e days were devoted to each health centre. On these days, all and its early accumulation have P been related to thet caries w s experience among children. s Despite that, neither thew target-age children visiting the centre were selected, i report in Iran has o denoted in 20-35 children per centre. The mothers were WHO database, nor the national h h (w resulting asked to give their consent to participate in the study; only any data regarding the T dental plaque in the young children. The aim of the present study was to teinvestigate the two refused. relationships between dental caries and idental plaque among s Mothers were first interviewed with a pre-tested, structured 12- to 36-month-olds in Tehran, Iran. a questionnaire and after that, the child was examined. The Keywords: Dental caries, infants’ oral health, parents’ education
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questionnaire covered background factors such as child’s date and order of birth, gender, primary caregiver, the mother’s age and the educational level of both parents. The age of the child was determined within an accuracy of one day.
Materials and Methods The present study was implemented in the public health centres of Tehran city. These centres consist of offices for general oral, occupational and family health and for vaccination and assessment of child development. Children of all socio-economic backgrounds receive childhood a
Information about the child’s primary caregiver was obtained along with alternatives such as mother, father, grandmother and others. For the mother’s age, the accuracy was within one year. The level of education was assessed separately for father and mother using a 7-point-scale ranging from
Institute of Dentistry, University of Helsinki, Helsinki, Finland, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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J Indian Soc Pedod Prev Dent - December 2006
Early childhood caries and dental plaque among 1–3-year-olds in Tehran, Iran
16-19, 20-25 and 26-36 months). The two youngest age groups became over-represented due to the recommended vaccine shots at 12 and 18 months of age. More than half of the children were the first born in the family and for 91%, mothers were the primary caregivers. The mothers’ ages ranged from 15 to 46 years (mean 27.8, 95% CI 27.4-28.3) with no differences by children’s age group (P=0.4) or gender (P=0.1). Parents’ level of education was low for 19% of children, moderate for 47% and high for 34%, with no differences between the age groups or genders of the children.
illiterate to doctorate degree. The educational level of parents was defined as the highest level of either parent’s education and then categorized into three: low (primary school or illiterate), moderate (diploma or high school education) and high (university education). For some further analyses, this was dichotomized as having a university education or not. For the clinical dental examinations, one of the authors (SM), having a five-year experience as practicing dentist, was further trained by an experienced paediatric dentist, head of the university paediatric department. The training ended into double examination of 10 children and the intraexaminer reliability, a Cohen’s kappa value, was 0.8 for recordings on dental plaque and 1.0 on caries. Dental examination was carried out with the help of a headlamp and a plane dental mirror with the mother and examiner sitting in a knee-to-knee position, the child on their laps and the mother controlling his/her feet and hands.
d a o l n s w n io do t a e Dental diagnoses were recorded for each tooth. Every tooth e c i l was recorded as present when visible in the mouth,fr b otherwise as absent. The criteria for caries diagnoses were r Prevalence ofuECC in.the youngest age group (12-15 months) according to the WHO recommendations. Decayed o teeth P ) f was 3%, being 9% for 16- to 19- and 14% for 20- to 25-month (dt) included the teeth with visually diagnosed cavitated e with oldswand 33%oformthe 26- to 36-month-olds (P0.05). ECC prevalence . age groups was not related to the tooth was recorded as sound (non-carious).la ECC was o defined n k i r w child’s birth order, his/her primary caregiver (mother or else) as the presence of any dmf teeth and severe ECC (S-ECC) as f d a o or to parents’ level of education. For the three youngest age caries on smooth surfaces. Dental plaque was visually e v n groups, all caries were on smooth surfaces; the prevalence inspected on the labial surfaces a of upper central incisors M k and recorded as (0) no plaque,s (1) plaque present at gingival d of S-ECC for these age groups was equivalent to that of ECC. y moree In the oldest age group, 26- to 36-month-olds, the prevalence i margin only and (2) abundant dental plaque covering b F tooth. d .m of S-ECC was 27%. than gingival margin of the D w in the Table 2 shows mean number of dt by parent’s level of teparticipate The mothers gave P informed consent to s w with a education. Among all children, those of more highly educated study. The subjects entered into the database sonly.were i o w parents exhibited lower dt (P
